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      Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients

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          Abstract

          Background

          Insulin resistance (IR) plays a vital role in the pathogenesis of Type 2 Diabetes Mellitus (T2DM). The mechanism of IR may be associated with inflammation, whereas the neutrophil-lymphocyte ratio (NLR) is a new indicator of subclinical inflammation. Scholars have rarely investigated the relationship between IR and NLR. This study aims to evaluate the relationship between IR and NLR, and determine whether or not NLR is a reliable marker for IR.

          Methods

          The sample consists of a total of 413 patients with T2DM, 310 of whom have a HOMA-IR value of > 2.0. The control group consists of 130 age and BMI matched healthy subjects.

          Results

          The NLR values of the diabetic patients were significantly higher than those of the healthy control (P < 0.001), and the NLR values of the patients with a HOMA-IR value of > 2.0 are notably greater than those of the patients with a HOMA-IR value of ≤ 2.0 (P < 0.001). Pearson correlation analysis showed a significant positive correlation of NLR with HOMA-IR (r = 0.285) (P < 0.001). Logistic regression analysis showed that the risk predictors of IR include NLR, TG and HbA1c. NLR (P < 0.001, EXP(B) = 7.231, 95% CI = 4.277–12.223) levels correlated positively with IR. The IR odds ratio increased by a factor of 7.231 (95% CI, 4.277–12.223) for every one unit increase in NLR.

          Conclusions

          Increased NLR was significantly associated with IR, and high NLR values may be a reliable predictive marker of IR.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12902-015-0002-9) contains supplementary material, which is available to authorized users.

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          Most cited references26

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          Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome.

          The neutrophil/lymphocyte ratio (NLR) has recently been described as a predictor of mortality in patients who undergo percutaneous coronary intervention. The aim of this study was to investigate the utility of admission NLRs in predicting outcomes in patients with acute coronary syndromes (ACS). A total of 2,833 patients admitted to the University of Michigan Health System with diagnoses of ACS from December 1998 to October 2004 were followed. Patients were divided into tertiles according to NLR. The primary end point was all-cause in-hospital and 6-month mortality. The ACS cohort comprised 564 patients with ST-segment elevation myocardial infarctions and 2,269 patients with non-ST-segment elevation ACS. Patients in tertile 3 had higher in-hospital (8.5% vs 1.8%) and 6-month (11.5% vs 2.5%) mortality compared with those in tertile 1 (p <0.001). After adjusting for Global Registry of Acute Coronary Events risk profile, patients in the highest tertile were at an exaggerated risk for in-hospital (odds ratio 2.04, p = 0.013) and 6-month (odds ratio 3.88, p <0.001) mortality. Admission NLR is an independent predictor of in-hospital and 6-month mortality in patients with ACS. This relatively inexpensive marker of inflammation can aid in the risk stratification and prognosis of patients diagnosed with ACS.
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            Atherosclerosis is an inflammatory disease

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              Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population

              Background Preliminary evidence has suggested the role of inflammation in development and prognosis of cardiovascular diseases and cancers. Most of the prognostic studies failed to account for the effects of co-morbid conditions as these might have raised the systemic inflammation. We used neutrophil lymphocyte ratio (NLR) as a measure of systemic inflammation and investigated its association with prevalent chronic conditions. Methods Present study is a cross sectional study conducted on population of Karachi, Pakistan. A detailed questionnaire about the demographic details of all subjects was filled and an informed consent obtained for blood sampling. Multinomial regression analyses were carried out to investigate the relationship between NLR and prevalent chronic conditions. Results 1070 apparently healthy individuals participated in the study. Proportion of individuals with hypertension was higher in middle and highest tertile of NLR as compared to the lowest tertile (18.2% & 16.1% compared to 11.8%). Individuals with hypertension were 43% (RRR = 1.43, 95% CI 0.94-2.20) and 66% (RRR = 1.69, 95% CI 1.09-2.54) more likely to be in the middle and highest tertile of NLR respectively compared to the baseline group. Similarly, individuals with diabetes mellitus were 53% (RRR = 1.53, 95% CI 0.93-2.51) and 65% (RRR = 1.65, 95% CI 1.01-2.71) more likely to be in the middle or highest tertile of NLR as compared to the baseline NLR group. Conclusions Systemic inflammation measured by NLR has a significant association with prevalent chronic conditions. Future research is needed to investigate this relationship with longitudinal data to establish the temporal association between these variables.
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                Author and article information

                Contributors
                1147290876@qq.com
                519535322@qq.com
                1766231973@qq.com
                928309396@qq.com
                2480226030@qq.com
                408146175@qq.com
                765139701@qq.com
                Journal
                BMC Endocr Disord
                BMC Endocr Disord
                BMC Endocrine Disorders
                BioMed Central (London )
                1472-6823
                2 March 2015
                2 March 2015
                2015
                : 15
                : 9
                Affiliations
                Department of Endocrinology, Zhujiang Hospital, Southern Medical University, # 253 Industry Road, Guangzhou, China
                Article
                2
                10.1186/s12902-015-0002-9
                4357061
                25887236
                5db5477c-b5ae-4c5a-b6f7-f8b6e7d89c60
                © Lou et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 31 October 2014
                : 17 February 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Endocrinology & Diabetes
                neutrophil-lymphocyte ratio,insulin resistance,inflammation,diabetes mellitus

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